bd4da6e3d9004660f803ef37a731b127 286414.pdf e56824aac192757bf26c325384bb7000ba5bd446 286414.pdf 6ff8ae94bdaa44526ebcf7bfc55f8fa9d59c021253718f4237f8dddf5a3f82ee 286414.pdf Title: Breastfeeding Disparities between Multiples and Singletons by NICU Discharge Subject: Multiple pregnancy increases the risk of a range of adverse perinatal outcomes, including breastfeeding failure. However, studies on predictive factors of breastfeeding duration in preterm twin infants have a conflicting result. The purpose of this observational study was to compare feeding practices, at hospital discharge, of twin and singleton very low birth weight infants. The study is part of a prospective survey of a national Spanish cohort of very low birth weight infants (SEN1500) that includes 62 neonatal units. The study population comprised all infants registered in the network from 2002 to 2013. They were grouped into singletons and multiples. The explanatory variables were first analyzed using univariate models; subsequently, significant variables were analyzed simultaneously in a multiple stepwise backward model. During the twelve-year period, 32,770 very low birth weight infants were included in the database, of which 26.957 were discharged alive and included in this analysis. Nine thousand seven hundred and fifty-eight neonates were multiples, and 17,199 were singletons. At discharge, 31% of singleton infants were being exclusively breastfed, 43% were bottle-fed, and 26% were fed a combination of both. In comparison, at discharge, only 24% of multiple infants were exclusively breastfed, 43% were bottle-fed, and 33% were fed a combination of both (p < 0.001). On multivariable analysis, twin pregnancy had a statistically significant, but small effect, on cessation of breastfeeding before discharge (OR 1.10; 95% CI: 1.02, 1.19). Risks of early in-hospital breastfeeding cessation were also independently associated with multiple mother-infant stress factors, such as sepsis, intraventricular hemorrhage, retinopathy, necrotizing enterocolitis, intubation, and use of inotropes. Instead, antibiotic treatment at delivery, In vitro fertilization and prenatal steroids were associated with a decreased risk for shorter in-hospital breastfeeding duration. Multiple pregnancy, even in the absence of pathological conditions associated to very low birth weight twin infants, may be an impeding factor for in-hospital breastfeeding. Keywords: breastfeeding; multiple pregnancy; neonate; premature birth; milk bank; pregnancy outcomes Author: Roser Porta, Eva Capdevila, Francesc Botet, Gemma Ginovart, Elisenda Moliner, Marta Nicolàs, Antonio Gutiérrez, Jaume Ponce-Taylor and Sergio Verd Creator: LaTeX with hyperref package Producer: pdfTeX-1.40.18 CreationDate: Thu Sep 12 08:44:16 2019 CEST ModDate: Thu Sep 12 08:44:16 2019 CEST Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 11 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 266262 bytes Optimized: no PDF version: 1.5 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- OAKKSJ+URWPalladioL-Ital Type 1 Custom yes yes no 77 0 TWYYIW+URWPalladioL-Bold Type 1 Custom yes yes no 78 0 MWJZGO+VnURWPalladioL-Bold Type 1 Custom yes yes no 79 0 ZKRFES+URWPalladioL-Roma Type 1 Custom yes yes no 80 0 FATHTC+Rpxr Type 1 Builtin yes yes no 81 0 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